Department of Radiology, Hacettepe University School of Medicine, Ankara, Turkey.
Department of Radiology, Suleyman Demirel University School of Medicine, Isparta, Turkey.
J Vasc Interv Radiol. 2021 Jun;32(6):890-895.e2. doi: 10.1016/j.jvir.2021.03.519. Epub 2021 Mar 13.
To evaluate the long-term outcomes of percutaneous treatment of renal cystic echinococcosis (CE) stratified by cyst stages according to the World Health Organization (WHO) classification.
Between January 1997 and February 2019, 34 patients with renal CE (18 women; mean age, 38 years) were treated with 3 different percutaneous techniques. According to the World Health Organization classification, the cysts were classified as CE1, CE2, CE3a, and CE3b. Puncture, aspiration, injection, reaspiration (PAIR) or standard catheterization was used for the dimension-based treatment of CE1 and CE3a cysts. Modified catheterization (MoCaT) was used to treat all CE2 and CE3b cysts. Technical and clinical success, complications, and reduction in cyst cavities were evaluated.
The technical success rate was 100%. PAIR, standard catheterization, and MoCaT were used to treat 12, 9, and 13 cysts, respectively. The only severe adverse event was a bacterial superinfection that occured in the cyst cavity of a patient (3%) treated with MoCaT. Four patients (12%) experienced mild/moderate periprocedural allergic adverse events and were managed conservatively. The mean length of hospital stay was 1, 5, and 7 days for patients treated with PAIR, standard catheterization, and MoCaT, respectively. The clinical success rate was 97%. In 1 of 34 cysts (3%), recurrence was detected and the cyst was successfully re-treated. During the 10.5-year follow-up period, 95% volume reduction was achieved. The median final cyst volume was 10 mL.
Renal CE can be successfully treated with minimum adverse events and recurrence rates using appropriate percutaneous techniques selected according to their stages as classified according to WHO.
根据世界卫生组织（WHO）分类，评估经皮治疗肾包虫病（CE）的长期结果，对不同囊型进行分层。
1997 年 1 月至 2019 年 2 月，34 例肾 CE 患者（18 例女性；平均年龄 38 岁）接受了 3 种不同的经皮治疗技术。根据世界卫生组织的分类，囊肿分为 CE1、CE2、CE3a 和 CE3b。基于体积的 CE1 和 CE3a 囊肿采用穿刺抽吸注射再抽吸（PAIR）或标准导管化治疗，所有 CE2 和 CE3b 囊肿采用改良导管化（MoCaT）治疗。评估技术和临床成功率、并发症以及囊肿腔缩小情况。
技术成功率为 100%。PAIR、标准导管化和 MoCaT 分别用于治疗 12、9 和 13 个囊肿。唯一严重的不良事件是 MoCaT 治疗的患者（3%）的囊肿腔内发生细菌继发感染。4 例（12%）患者出现轻度/中度围手术期过敏不良反应，采用保守治疗。PAIR、标准导管化和 MoCaT 治疗的患者平均住院时间分别为 1、5 和 7 天。临床成功率为 97%。34 个囊肿中有 1 个（3%）复发，该囊肿成功进行了再次治疗。在 10.5 年的随访期间，实现了 95%的体积缩小。最终囊肿体积中位数为 10 mL。
根据 WHO 分类，采用适当的经皮治疗技术，根据其分期进行选择，可以成功治疗肾 CE，且不良事件和复发率均较低。
